What is cancer?
Cancer develops when cell growth becomes uncontrolled. Cancer cells are insensitive to the chemical signalling molecules that modulate cell growth and division. This ability to ignore the usual restraints on cellular growth and division apparently occurs as a result of genetic mutation, which alters oncogene or tumour-suppressor gene activity. An oncogene is a gene that, when mutated or expressed at high levels, can turn a normal cell into a tumour cell.
With cell replication, these detrimental gene alterations are transmissible to daughter cells, which establishes a growing colony of mutated cells that can replicate uncontrollably and endlessly.
With increasing cell growth, cancer cells spread or infiltrate to involve other organs, displacing normal tissue and severely depleting nutrient and metabolic resources, which results in death either from cancer cachexia or from mechanical disruption of normal organ function. Cancer cachexia describes a syndrome of progressive weight loss, lack of appetite, and persistent wearing down of host body cell mass in response to a primary or secondary cancer.
A benign tumour (also called a mass or lesion) is not a cancer, while a malignant tumour is a cancer. Certain types of benign tumours are surgically removed because their likelihood of becoming malignant is high.
A risk factor is any factor that increases a person’s chances of developing a disease, such as cancer. Risk factors such as lifestyle or environmental factors can be modified. Risk factors such as age, race, family history, and inherited factors are determined at birth and cannot be modified.
Having a risk factor for a disease doesn’t mean a person will definitely develop that disease, but it does mean a person is more likely to develop that disease. Some risk factors, for example cigarette smoking, are fully recognised as causing cancer, while others are less well understood.
A person can develop a disease without having any predisposing risk factor. So a person who has never smoked tobacco or illicit drugs can develop lung cancer.
Risk factors for cancer include:
- Tobacco smoking
- Alcohol consumption
- Diet – for example, high intake of particular foods (such as processed meat and foods that are high in fat) is associated with an increased risk of some types of cancer
- Overweight and obesity
- Physical inactivity
- UV radiation from sunshine
- Infections – some types of human papillomavirus (HPV) infection can be associated with cervical and other cancers, and chronic hepatitis B or C infection can be associated with liver cancer
- Occupational exposure to agents, including chemicals, dusts and industrial processes, and
- Family history and genetic susceptibility.
What are the most common types of cancer?
The most common cancers in Australia are non-melanoma skin cancer, prostate, bowel, breast, melanoma, and lung cancer.
Skin cancer accounts for approximately 80% of new cancers and exposure to UV radiation from the sun or sun beds causes most of these. In Australia skin cancer rates are among the highest in the world. Each year more than 434,000 people are treated for one or more non-melanoma skin cancers, which include non-life-threatening basal cell carcinoma, and squamous cell carcinoma. Another group of non-invasive skin cancers that requires treatment to prevent cancer includes solar keratosis, Bowenoid keratosis, and squamous cell carcinoma in-situ.
Melanoma is the most dangerous form of skin cancer and the fourth most common cancer diagnosed in Australia. Australia and New Zealand share the world’s highest incidence rate for melanoma. In Australia during 2011, there were 1544 melanoma-related deaths.
Find out more about skin cancer diagnosis, signs and symptoms, causes, and prevention. MORE>
In Australia, prostate cancer is the most common cancer diagnosed. During 2007 prostate cancer accounted for nearly 3000 deaths, which was 13% of all cancer deaths in men.
Older men are more likely to develop prostate cancer, with 85% of cases diagnosed in men more than 65 years of age. A man with benign prostatic hypertrophy shows the same symptoms as prostate cancer, but a general practitioner or urologist can usually differentiate between these two prostate diseases through a blood test, called a PSA.
Find out more about prostate cancer diagnosis, signs and symptoms, causes, and prevention. MORE>
Bowel cancer occurs when bowel wall cells grow in an abnormal and uncontrolled manner. Colorectal cancer is a cancer of the lower section of the digestive system, called the large bowel, which includes the colon, rectum, and anal canal.
Upper sections of the digestive system are the oesophagus, stomach, duodenum, and small bowel or small intestine.
Environmental factors, especially diet, play a significant role in the development of bowel cancer. Most bowel cancers start as adenocarcinomas, which mean they start in gland cells of the bowel wall. Bowel cancers tend to grow slowly and present few symptoms in the early stages.
As a person ages, polyps can grow in the bowel wall and these polyps might become cancerous. Not all polyps develop into cancer, but removing a polyp reduces the risk of bowel cancer. MORE>
The majority of breast lumps are benign. Most breast lumps turn out to be fibrosis or simple cysts – called fibrocystic disease. These changes become more apparent just before a woman’s menstrual period. Fibroadenomas and intraductal papillomas are also benign breast lumps, but women with these types of lesions have a higher likelihood of developing breast cancer. A breast ultrasound can help determine the nature of a palpable lump.
Breast cancer affects mostly older women, but can develop at any age. Most women survive breast cancer. Most breast cancers start in the milk ducts of the breast, but others start in the breast lobules that produce milk. A breast cancer that starts in the connective tissues that hold the breast together is called a sarcoma, but these are rare.
Breast cancer can spread to the lymph nodes under the armpit and around the chest. Lymph node involvement allows a breast cancer to spread through the bloodstream to other organs or areas, such as the bones, liver, or lungs.
Although much less likely, men can also develop breast cancer. Cancer researchers now know much more about risk factors that indicate a stronger likelihood for cancer. Learn about the risk factors that may apply to you.
The lungs are part of the respiratory system that enables us to breath. The lungs consist of a series of tubes called bronchi and bronchioles that terminate in small air sacs called alveoli.
Lung cancer occurs when lung cells grown in an abnormal uncontrollable fashion. In Australia, lung cancer remains the leading cause of cancer deaths in both men and women.
In men, lung cancer and is the second highest cause of all deaths and in women the fifth highest cause of all deaths. In men, the incidence and death rates have declined in recent times, but in women the incidence and death rates have increased. Smoking cigarettes is the main cause of lung cancer. MORE>
Cancer facts and trends
In Australia, an estimated 124,910 new cases of cancer will be diagnosed, during 2014. The number of new cancer cases each year is expected to rise to 150,000, by 2020.
By the age of 85 years, 50% of Australian men and 33% of Australian women will be diagnosed with some form of cancer.
Cancer is a leading cause of death in Australia. During 2011, at least 43,700 people died due to cancer, which accounted for approximately 33% of deaths.
The number of cancer deaths has increased during the last 30 years, in part due to population growth and our aging population. However, the death rate from cancer fell by 16% during that time, because of increased awareness, early detection and treatment, and national screening programs for prostate and breast cancer.
Since 1990, the survival rate for many common cancers has increased by 30%, because treatment options have improved significantly.
Cancer costs more than $3.8 billion in direct health system costs, which is 7.2% of Australia’s annual health expenditure.
What are the signs and symptoms of cancer
Signs and symptoms are both indicators that something is not right in the body. Cancer can cause a variety of signs or symptoms, but the signs and symptoms can assist your doctor to determine the nature of disease, where the cancer is, the size, and any effect on adjacent organs or tissues.
Unfortunately, occasionally cancer can grow to a significant size before signs or symptoms become evident. For example, pancreatic cancer will not become apparent until the bile duct is blocked, which will result in jaundice causing a yellow discolouration of the eyes and skin.
Symptoms such as fever, extreme fatigue, or unexplained weight loss are associated with cancer. In most cases, if signs and symptoms lead to early cancer detection, early treatment will result in better outcomes, even a cure in many cases when surgical removal is possible.
In most cases and signs and symptoms won’t be due to cancer, but a doctor needs to perform a thorough assessment to rule out cancer as a cause. Seeing a medical doctor about any of these symptoms will give a person peace of mind and could lead to life-saving treatment if cancer is the cause.
Any of these symptoms warrant a medical consultation:
- Unexplained weight loss
- Skin changes
- Change in bowel habits or bladder function
- Sores that do not heal
- White patches inside the mouth or white spots on the tongue
- Unusual bleeding or discharge
- Thickening or lump in the breast, scrotum, underarm, groin, neck, or other parts of the body
- Indigestion or trouble swallowing
- Recent change in a wart or mole or any new skin change
- Nagging cough or hoarseness
How to reduce the likelihood of cancer
Australia leads the way in cancer research. Investigations into the cause of cancer and better treatments are discovered every day. What is understood about cancer prevention is still evolving. However, choosing a healthier lifestyle can reduce your risk of cancer. y the lifestyle choices you make. Doctors at the Mayo Clinic recommend these seven cancer-prevention tips.
1. Don’t use tobacco
Using any type of tobacco puts you on a collision course with cancer. Smoking has been linked to various types of cancer — including cancer of the lung, bladder, cervix and kidney. And chewing tobacco has been linked to cancer of the oral cavity and pancreas. Quitting smoking is one of the most important health decisions you can make.
2. Eat a healthy diet
Although making healthy selections at the grocery store and at mealtime can’t guarantee cancer prevention, it might help reduce your risk.
Eat plenty of fruits and vegetables, limit fat, and if you choose to drink alcohol drink in moderation.
3. Maintain a healthy weight and keep physically active
Maintaining a healthy weight might lower the risk of various types of cancer, including cancer of the breast, prostate, lung, colon and kidney.
Physical activity counts, too. In addition to helping you control your weight, physical activity on its own might lower the risk of breast cancer and colon cancer.
4. Protect yourself from the sun
Skin cancer is one of the most common kinds of cancer — and one of the most preventable.
- Stay out of the sun between 10 am and 4 pm
- When outdoors seek shade as much as possible
- Cover exposed areas. Wear tightly woven, loose fitting clothing that covers as much of your skin as possible. Wear sunglasses and a broad-rimmed hat.
- Apply generous amounts of 50+ sunscreen when outdoors, and reapply every two hours, and
- Avoid tanning beds and sunlamps.
5. Get immunised
Cancer prevention includes protection from certain viral infections. Talk to your doctor about immunization against Human Papillomavirus and Hepatitis B. The HPV vaccine, which prevents cervical cancer in women, is available to both men and women age 26 or younger who didn’t have the vaccine as adolescents.
6. Avoid risky behaviours
Practice safe sex. Limit your number of sexual partners, and use a condom when you have sex. If you chose to use drugs, don’t share needles.
7. Get regular medical care
Regular self-exams and screenings for various types of cancers — such as cancer of the skin, colon, prostate, cervix and breast — can increase your chances of discovering cancer early, when treatment is most likely to be successful. If you’re a woman, ask your doctor if you’re unsure about how to self-examine your breasts or when and how often you should have screening mammograms, and pap smear tests.
What is skin cancer?
Skin cancer occurs when the skin cells are damaged in some way and the skin cells undergo uncontrolled abnormal growth. When the DNA within the skin cells becomes damaged and doesn’t repair properly, mutations lead skin cells to multiply rapidly to form cancerous lesions.
In Australia between 95 to 99% of skin cancers result from overexposure to UV radiation. Both regular exposure to UV radiation and each episode of sunburn, year after year, can lead to skin cancer.
A person with fair skin, freckles, light eye colour, and light or red hair colour who burns easily in the sun is at higher risk for skin cancer. A person with an increased number of unusual moles, or who has had a previous skin cancer, also has a higher risk. A person with a depressed immune system has an increased risk for melanoma.
How do doctors diagnose skin cancer?
When a person presents to his or her doctor because of a skin abnormality, skin cancer must be excluded. Early identification and treatment means a better chance of avoiding surgery or, in the case of a serious melanoma or other skin cancer, potential disfigurement or even death.
Non-melanoma skin cancers can present in a variety of ways, including any crusty, non-healing sores, a small red or pale lump, or a new spot, freckle, or mole that has changed in size or colour.
A person at high risk of melanoma should perform regular self-checks for lesions and see a dermatologist at least once per year.
Your doctor might biopsy a skin lesion, which means removing a sample of tissue for a pathologist to examine under a microscope, to determine the exact nature of the abnormality. A biopsy will determine cancer stage, which means how advanced the cancer is, and help to determine the most appropriate treatment.
How you can prevent skin cancer
The best prevention for skin cancer is protection from the UV radiation from the sun or sun beds.
You can protect yourself and your family from skin cancer in these five ways:
- Seek shade
- Wear sun protective clothing that covers as much of your body as possible
- Wear a broad-brimmed hat that shades your face, neck, and ears
- Wear wrap-around sunglasses that meet Australian Standards for sun protection
- Apply SPF50+ broad spectrum, water resistant sunscreen liberally to clean, dry skin, at least 20 minutes before being exposed to the sun, and reapply at least every two hours when outdoors
Always prepare for exposure to UV radiation from the sun when going outdoors, even for a brief period of time, through a combination of multiple sun protective behaviours.
Avoid going outdoors unprotected during the hottest part of the day between 10am – 2pm (or 11am – 3pm during daylight saving).
Sunscreen alone is not adequate protection and should not be used to extend the time a person spends in the sun.
Sun beds and solariums also emit UV radiation, so be aware of the risks associated with artificial tanning.
The Bureau of Meteorology (BOM) reports the daily SunSmart UV Alert, which identifies when the UV level is 3 or more, through the BOM website, in daily newspapers and on the Cancer Council website. An app for smart phones is also available.
What is prostate cancer?
Prostate cancer is Australia’s most commonly diagnosed male cancer and affects one in every five men more than 85 years of age. Only men have a prostate gland, an exocrine gland at the base of the bladder that forms part of the male reproductive system.
In most cases prostate cancer progresses very slowly, compared with other cancers, although some men can develop a more aggressive form. Many men die of old age and other unrelated problems without any knowledge that they have prostate cancer.
Prostate cancer is caused by dysplastic change involving the glands and ducts of the prostate, which may be a precursor of adenocarcinoma. The Gleason Score enables doctors to classify how advanced prostate cancer is and determines the most appropriate treatment.
Advancing age is the main risk factor. Other risk factors include a family history of prostate, breast, or ovarian cancer, race, obesity (BMI >30), and genetics.
The gene that causes breast cancer can also cause prostate cancer. A man with a genetic fault in the BRCA2 gene has almost four times the risk of developing prostate cancer compared with the general population, and is likely to have a more aggressive type of prostate cancer.
Risk factors for prostate cancer can include:
- Being more than 50 years of age
- Having a family history of prostate cancer
- Having a family history of breast or ovarian cancer
- A diet high in fats and low in fresh fruits and vegetables
- High testosterone levels
- Males of African descent are at higher risk
Early detection of prostate cancer allows more effective treatment and better outcomes. When prostate cancer is confined to the gland and hasn’t spread to the surrounding tissue it might be curable. However, early stage prostate cancer might not present any symptoms, which is why screening, to measure PSA, is important for men more than 50 years of age.
The tube that allows urine to pass from the bladder and out of the penis, called the urethra, goes through the prostate gland, which is involved in controlling the flow of urine.
The symptoms that develop usually include at least one or a combination of:
- Urinary frequency
- Having to get up more often during the night to urinate
- Finding it harder to start urinating or keep urinating
- Blood in the urine or semen
- Painful urination or ejaculation
- Decreased libido
- Difficulty achieving or maintaining an erection
How do doctors diagnose prostate cancer?
A doctor will take into account age, family history, other related disease, and should perform a digital rectal examination (DRE) to assess for prostate cancer. An annual DRE and blood test that measures prostate-specific antigen (PSA) is essential for early detection of prostate cancer.
Following initial examination and blood tests, further diagnostic testing such as rectal ultrasound, prostate biopsy, or MRI might be needed to assess the presence or extent of disease.
A baseline PSA taken at 40 years of age can help predict future risk for prostate cancer, and identify the small number of aggressive cancers that occur in younger men.
PSA is a protein found in the blood and semen in men made by the prostate gland. A high PSA level means a higher likelihood of prostate cancer.
The symptoms of benign prostatic hypertrophy (BPH) are very similar to prostate cancer, but BPH is simply a benign (non-cancerous) enlargement of the central prostate gland and is common in older men.
BPH can make it more difficult for a man to pass urine, because of pressure on the urethra. Incomplete bladder emptying can cause an increased frequency of emptying the bladder, which is more noticeable at night. BPH can be treated with medication or surgically if symptoms are significant.
Prostatitis means inflammation of the prostate gland caused by an infection, which is treated with antibiotics. It is not a cancer. The prostate becomes sore and irritated, which can be quite debilitating. The lower urinary tract symptoms for prostatits are similar to those for prostate cancer and BPH.
A man is likely to visit his doctor for prostate testing because of:
- General check up after 50 years of age
- Recent relative or friend diagnosed with prostate cancer
- Family history of prostate cancer
- Onset of urinary or reproductive symptoms
How you can prevent prostate cancer – ways to reduce your risk
Despite much research to find a way to prevent prostate cancer, no method of prevention has emerged. Men more than 50 years of age should have a prostate check each year, in particular those with a high risk.
Prostate cancer testing has many benefits. While testing doesn’t prevent cancer, early detection enables more effective treatment, even a cure, reduces the likelihood of secondary cancer, and improves long-term survival.
As with all disease processes, a man can reduce his risk for prostate cancer by making healthy choices, such as exercising and eating nutritious foods. Maintaining a healthy weight (BMI < 30) is important in preventing prostate cancer.
What is bowel cancer?
While bowel cancer is a serious form of cancer, if diagnosed in the early stages it can be treated and cured. In Australia, a person more than 50 years of age can have bowel cancer screening, which tests for occult blood in the faeces. If the test is positive, an endoscopy of colonoscopy is necessary to diagnose the exact cause and location of the intestinal bleeding.
The human digestive system comprises all anatomy from the mouth to the anus, and includes the oesophagus, stomach, duodenum, small intestine, colon, rectum, and anus. Bowel cancer, or colorectal cancer, is any cancer of the colon, rectum, or anus.
One in every 12 Australians is likely to develop bowel cancer during their lifetime. After lung cancer, bowel cancer is the second most common cause of cancer-related deaths in Australia, with more than 14,000 people diagnosed each year.
As with other human cancers, the exact cause of bowel cancer is not clearly evident. But as with other cancers, risk factors are known that increase the risk of a person developing bowel cancer. These include:
- Advanced age – bowel cancer more commonly affects people more than 50 years of age
- Inheriting one of two uncommon genetic disorders – familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (HNPCC)
- Previous history of bowel cancer
- Strong family history of bowel cancer
- Ulcerative colitis for more than eight to 10 years
- Diet high in red and processed meat
- Excess alcohol (more than 12.5 units a week)
- Tobacco smoking
- Being overweight or obese – particularly for men
What are the signs and symptoms for bowel cancer?
Symptoms that often precede a diagnosis of bowel cancer include:
- Blood or mucous in the faeces
- Symptoms of anaemia (pale skin, fatigue, low blood pressure)
- Change in bowel habit (diarrhoea or constipation)
- Abdominal pain, cramping, or bloating
- Unexplained weight loss
- Unexplained tiredness or constant fatigue.
These symptoms can accompany other diseases that are not cancerous. Just because a person has one or more of these symptoms does not mean he or she has bowel cancer. However, any of these symptoms need further investigation by a medical doctor.
How do doctors diagnose bowel cancer?
A person with symptoms associated with bowel cancer will usually be referred to a gastroenterologist for consultation and diagnostic testing.
The types of investigations that examine the bowel include:
- Rectal examination
- Colonoscopy or endoscopy (upper GI tract)
- Barium enema
- X-ray, ultrasound, rectal ultrasound, CT scan, or MRI scan
- Blood tests, including a carcinoembryonic antigen (CEA) test
In Australia, a person more than 50 years of age is encouraged to undergo a simple-to-perform bowel cancer screening. Even if you have no symptoms and have no family history of bowel cancer, screening for bowel cancer can provide peace of mind.
How you can prevent bowel cancer
A healthy diet and lifestyle play an important role in keeping your bowel healthy and working optimally.
A diet high in fibre and low in fat is recommended and keeps the gut ensures adequate gut motility. Eat a nutritious diet including five serves of vegetables and two serves of fruits per day and maintain a healthy body weight for your height.
Participate in moderate to vigorous levels of physical activity for 30 to 60 minutes per day. For example, walk for at least 30 to 60 minutes on most days of the week. Eating a healthy diet can help prevent up to one third of all cancers, including bowel cancer. By switching to a healthier diet, a person can reduce his or her risk of cancer, in particular bowel cancer, and improve overall health.
Reduce your risk of bowel cancer by:
- Eating a healthy diet, including plenty of vegetables and fruit and only small amounts of animal fat
- Eating moderate amounts of lean red meat as part of a mixed diet including carbohydrates, vegetables and fruit, and dairy products
- Eating limited amounts of processed meats
- Maintaining a healthy body weight
- Exercising regularly
- Quitting smoking
- Modifying alcohol intake
If you smoke – now is the time to stop.
For healthy men and women, drinking no more than two standard drinks on any day reduces a person’s risk of harm from alcohol-related disease or injury over a lifetime.
What is breast cancer?
Breast cancer develops from various types of breast cells, but usually begins in the lining of lactiferous or milk ducts (ductal cancinoma) or the lobules that supply milk (lobular carcinoma).
The adult female breast consists of fat, connective tissue, thousands of breast lobules, and numerous lactiferous ducts, which radiate from the nipple. The most common type of breast cancer is ductal carcinoma. While of concern, ductal carcinoma in situ (DCIS) might be managed conservatively because the cancer is limited to the milk duct and is likely to grow slowly. However, a breast surgeon might recommend surgical excision of a DCIS lesion, to prevent progression to more advanced disease.
Non-invasive breast cancer means the cancer is limited to the site of origin, but these cancers may grow to invade the surrounding breast tissue.
Invasive breast cancer means the cancer has affected the surrounding tissue and cancer cells may reach lymph nodes under the armpit (axilla). Cancer cells may travel through the bloodstream from the lymphatic system to metastasise in other organs, such as the bones, liver, or lung.
Early detection of breast cancer means finding the disease in its early stage of development, which usually results in a better chance of recovery. A woman’s breasts undergo normal cyclic changes that correspond to the menstrual cycle. Regular self-examination at the end of each menstrual period will enable early detection, diagnosis, and treatment if needed.
Benign breast lesions (non-cancerous) include simple cysts, which contain fluid, and fibroadenomas, which are solid tumours found in young women. Because these present as a breast lump and can mimic the signs for breast cancer, benign lesions need further investigation using mammography and/or ultrasound.
For women, breast cancer is the most common cancer. In Australia during 2009, more than 13,700 people were diagnosed with breast cancer. The risk of being diagnosed with breast cancer by 85 years of age is one in eight for women and one in 724 for men. During 2007, 2680 women and 26 men died of breast cancer in Australia.
Thanks to advances in early detection and treatment, most women survive breast cancer. For men, breast cancer is rare. During 1982, just 61 men in Australia were diagnosed with breast cancer, but that number increased to 113 in 2008. Any male who notices a change in breast size and shape, or feels a lump should consult a medical doctor.
What are the risk factors for breast cancer?
A woman’s risk of breast cancer increases with age, with the majority of women diagnosed between 50 and 69 years of age. The mean age of diagnosis is 60 years of age.
Approximately 5% to 10% of breast cancers are due to a known genetic mutation or a strong family history.
Breast cancer is the most common cancer affecting Aboriginal and Torres Strait Islander (ATSI) women. However, ATSI women were significantly less likely to be diagnosed with breast cancer than non-ATSI Australian women during the period 2004 to 2008.
Women from Culturally and Linguistically Diverse (CALD) groups were found to have a relatively lower incidence of breast cancer compared with Australian-born women.
What are the different types of breast cancer?
Abnormal changes confined to the lactiferous ducts are called ductal carcinoma in situ (DCIS) and abnormal changes confined to the breast lobules are called lobular carcinoma in situ (LCIS). Because these two cancers are confined to the site of origin (in situ) they are deemed to be pre-cancerous, non-invasive, and slow growing. However, at some later stage an in-situ cancer might become invasive.
Invasive ductal carcinoma is the most common type of breast cancer, accounting for 80% of breast cancers. The cancer leaves the confines of the lactiferous duct to invade the surrounding breast tissue.
Invasive lobular carcinoma starts in the lobules, but goes on to invade the surrounding breast fat and connective tissue. This type of cancer accounts for approximately 10% of breast cancer.
Inflammatory breast cancer is quite rare and accounts for 1% to 3% of breast cancer. Unfortunately this type of cancer can be mistaken for mastitis and treated with antibiotics, but the symptoms won’t improve.
Unlike other breast cancers, inflammatory breast cancer affects the entire breast, which becomes red and feels warm. The skin becomes thickened and looks like orange peel. Because no lump is apparent on mammogram or ultrasound, the cancer may go undetected.
Phylloides are rare tumours of the breast connective tissue. These tumours are usually benign, but may become invasive.
The terms metastatic, secondary, and advanced all mean that the primary cancer that has spread from the breast to other organs or tissues in the body, such as the lymph nodes, brain, liver, lung, or bones.
Sub-types of invasive breast cancer that have a better prognosis include:
- Adenoid cystic carcinoma
- Low-grade adenosquamous carcinoma
- Medullary carcinoma
- Mucinous carcinoma
- Papillary carcinoma
- Tubular carcinoma
Sub-types of invasive breast cancer that have a worse prognosis include:
- Metaplastic carcinoma, including spindle cell and squamous
- Micropapillary carcinoma
- Mixed carcinoma – has features of invasive ductal and lobular carconoma
Paget disease of the nipple is a rare breast cancer that starts in the milk ducts and spreads to the skin of the nipple and the areola. The skin of the nipple and areola appears scaly and red and might bleed or ooze, with burning or itching of the area.
Breast cancer is classified into stages to describe how advanced the disease is.
A woman with early breast cancer has an invasive cancer that is contained in the breast, which may or may not have spread to lymph nodes. Stage I, II A and B and III A are early-stage breast cancers than have not spread to distant areas, apart from the lymph nodes.
A woman with locally advanced breast cancer has an invasive breast cancer that has advanced into other body tissues, such as the chest wall.
A woman with secondary breast cancer (also called metastatic breast cancer) has an invasive breast cancer that has spread the other body or organs, such as the liver, lungs, bones, or brain.
What are the signs and symptoms for breast cancer?
Only a patient can feel a symptom, such as pain or headache. While a sign is something that a patient or doctor both can appreciate, such as skin dimpling or a palpable lump.
A person should consult a doctor if any of these signs or symptoms appear:
- A lump in a breast
- A pain in the armpits or breast that does not seem to be related to menstruation
- Pitting or redness of the skin of the breast; like the skin of an orange
- A rash around or on one of the nipples
- A swelling or lump in one of the armpits
- An area of thickened tissue in a breast
- One of the nipples has a discharge of clear or bloody fluid
- The nipple changes in appearance; it may become sunken or inverted
- The size or the shape of the breast changes, or
- The nipple-skin or breast-skin may have started to peel, scale or flake.
How do doctors diagnose breast cancer?
From 40 years of age, all women in Australia are eligible to have a free screening mammogram (X-ray of the breast) every two years through the BreastScreen Australia Program. Mammograms can detect up to 90% of breast cancers, even those a woman can’t feel and as small as a grain of rice.
If you are less than 40 years of age and feel a lump, your doctor may recommend a mammogram plus ultrasound, or under 35 years just an ultrasound. Young breasts are denser, which decreases the sensitivity of mammograms to detect changes. Ultrasound will differentiate benign lesions, such as a cyst or fibroadenoma, from a cancer, although a biopsy might be needed to confirm the diagnosis. Your doctor will write a referral for any medical imaging tests you need.
If you suspect you have breast cancer, either due to your symptoms or because your mammogram has shown an abnormality, further tests such as an ultrasound or fine needle aspiration (FNA) may be needed to define the problem.
An FNA involves taking a sample of tissue cells from the region of interest using a fine needle. A specialist pathologist then examines the cells under a high-powered microscope to assess for cancer cells. Occasionally, a core biopsy, using a larger needle is necessary for optimal assessment. If breast cancer is found, a breast surgeon will evaluate the type, stage, and grade of the cancer and discuss with you the best options for treatment.
A person with newly diagnosed breast cancer will benefit greatly from taking time out to absorb the information doctors provide and actively participating in your health care. Speak up if you have concerns or questions, and keep asking until you understand. Taking a friend or family member along to consultations means there are two sets of ears to hear and absorb the information.
For more information and to hear about other women’s stories you can visit the Breast Cancer Network Australia website, or call the information line on 1800 500 258.
How you can prevent breast cancer
Breast cancer awareness and early detection is the best way to survive.
Find time each and every month to self-examine your breasts. First, look at your breasts in the mirror and compare the size and shape – right with left. Feel your breasts in the bath or shower, lying down, or when getting dressed.
Raise your arm above your head and feel the entire breast tissue from your collarbone to below your bra line, and into the underarm, for any new lump or thickening of the breast tissue.
Feel near the surface using the tips of your fingers, and then feel the deeper tissues using the flat part of your fingers. If you notice any changes, make a mental note of the location of the area, or mark the skin with a felt pen, and consult your doctor as soon as you can.
Breast cancer awareness and early detection is the best way to survive. Find time each and every month to self-examine both breasts.
What is lung cancer?
Lung cancer is the fifth most common cancer in Australia, with 9954 newly diagnosed cases during 2008. Survival rates for lung cancer are relatively low, with a relatively low five-year relative survival rate of 14%.
Lung cancer occurs when abnormal cells in one or both lungs grow in an uncontrolled way. Small cell carcinoma arises from the central bronchi (airway) and accounts for approximately 12% of lung cancer. Non-small cell carcinoma arises in the smaller, more peripheral airways and alveoli, and accounts for more than 60% of lung cancers, including squamous cell carcinoma, adenocarcinoma, large cell carcinoma, and bronchiolo-alveolar cell carcinoma.
Mesothelioma is a cancer that develops in the lung in response to repeat or long-term exposure to asbestos. Mesothelioma forms in the lining of the lung, heart, abdomen, or testis. However, lung tumours are the most common form. Mesothelioma is considered an aggressive form of cancer and life expectancy from the time of diagnosis averages eight to 18 months.
What are the signs and symptoms for lung cancer?
Lung cancer is a destructive disease that attacks vital lung cells and tissues. Not all lung cancers are symptomatic. Some are found incidentally on a chest X-ray for cardiovascular disease or general health check.
Some common symptoms of lung cancer include:
- Coughing up blood from the lungs
- New or changed cough
- Chest pain or discomfort
- Shortness of breath
- Hoarseness of the voice
- Unexplained weight loss or loss of appetite, or
- Chest infection that doesn’t resolve.
While many of these symptoms can be associated with seasonal colds and chest infections, if a person has any of these symptoms for more than a week, in particular when aged more than 65 years of age, a doctor should be consulted for further assessment. Lung cancer is most commonly diagnosed in people 65 to 79 years of age.
What are the risk factors for lung cancer?
Any factor associated with an increased likelihood of developing lung cancer is called a risk factor; some of which can modified but others are linked to family and age.
Smoking cigarettes or exposure to cigarette smoke causes up to 90% of lung cancers in men and approximately 65% of lung cancers in women. The incidence rate increases sharply after 50 years of age.
The risk factors for lung cancer are:
- Smoking tobacco or illicit drugs
- Being around others who smoke (second-hand smoke)
- Environmental exposure to asbestos, diesel exhaust fumes, or radon gas
- Personal or family history of lung cancer, or
- Previous lung disease such as lung fibrosis, chronic bronchitis, emphysema, and pulmonary tuberculosis.
How do doctors diagnose lung cancer?
When a person presents with any of the signs or symptoms of lung cancer, a doctor will perform a physical examination that involves listening to the sounds made during deep inspiration and expiration, and coughing. A chest X-ray will demonstrate fluid, congestion, and any mass or scarring of the lungs. A sputum sample might be sent to a pathologist for culture analysis.
A lung CT uses a sophisticated array of X-rays to compile a cross-sectional image of the lungs. While a plain X-ray produces an image of the chest superimposed from back to front, a CT produces a multitude of cross-sectional images, which enable a better understanding of exactly where pathology is located.
In order to clarify findings, a doctor might request a bronchoscopy, which involves passing an optical cable down the trachea (wind pipe) while under anaesthetic. This type of imaging directly visualises the bronchi and smaller airways that enable air to pass from the nose and mouth into the alveoli, which are the tiny air sacs that make up the lungs.
A bronchoscopy often includes a biopsy of the area of interest, in order to determine the exact nature of a lesion. A sample of tissue is taken and a pathologist examines the tissue using special stains and a high-powered microscope.
Understanding the risk factors for lung cancer is the first step in preventing lung cancer, because many of the risk factors can be modified. While it may be challenging, quitting smoking is the most important step in preventing lung cancer. Avoiding environmental exposure to known lung cancer precursors, such as asbestos, is essential. If you live with someone who smokes, encourage him or her to stop smoking. Inhaling someone else’s cigarette smoke is just as dangerous as smoking. Quit smoking>
Understanding the risk factors for lung cancer is the first step in preventing lung cancer, because many of the risk factors can be modified.
While it may be challenging, quitting smoking is the most important step in preventing lung cancer. Avoiding environmental exposure to known lung cancer precursors, such as asbestos, is essential. If you live with someone who smokes, encourage him or her to stop smoking. Inhaling someone else’s cigarette smoke is just as dangerous as smoking. Quit smoking>
How conventional medicine manages the treatment of cancer
Surgical removal of cancer involves cutting out the tumour or tumours, including a margin of normal tissue around the cancer to ensure the entire disease is excised. In most cases just the ‘lump’ is removed, but sometimes the entire organ (kidney, lung, breast) is surgically removed. Because skin cancers are superficial, they can be removed using cryotherapy, topical chemotherapy, laser therapy, or surgery.
Except for skin cancer surgery, most surgery to remove a tumour is major surgery performed under general anaesthetic, with a few days in hospital after surgery to recover. Not every person with cancer is fit enough for surgery, which carries a risk. A person with lung cancer might not be suitable for surgery because of generalised lung damage caused by smoking, such as emphysema.
Radiotherapy uses high-energy X-rays (radiation) to kill cancer cells. If detected early enough, radiation might cure early cancers, before wider invasion. Radiation can be used to shrink the size of tumours, which might relieve pain or other symptoms.
Radiotherapy is carefully planned and targets just the tumour, to ensure the surrounding healthy tissue is not affected. Radiotherapy treatment is usually delivered in several sessions over a number of weeks. The treatment is not painful, but causes fatigue and reddening of the skin.
Chemotherapy uses intravenous drug delivery to kill cancer cells systemically. The drugs kills the cancer cells, but also affects other fast-growing normal cells in the body, which might result in hair loss, vomiting, and fatigue. Once chemotherapy treatment is finished, any symptoms related to chemotherapy will stop and hair will grow back.
Hormones are chemicals produced by glands such as the ovaries and testes. Hormone therapy might involve the surgical removal of the glands that are producing the hormone causing cancer growth.
Alternatively, hormone therapy might involve taking medication that interferes with the activity of hormones or stops the production of hormones. These treatments are commonly used for prostate, breast, and uterine cancers.
A hormone receptor test for these types of cancer will determine whether the cancer cells are sensitive to hormone therapy, and reveal more information about the tumour and treatment options.
How do doctors treat skin cancer?
The best way to treat non-melanoma skin cancers is removal through one, or a combination of the following: topical fluorouracil (Efudex) and imiquimod creams (Aldara), cryotherapy, photodynamic therapy, surgical removal, or radiotherapy. If the cancer is more advanced, an area around and deep to the affected tissue might also be removed to ensure complete removal.
While non-surgical removal is less invasive than surgical removal, one disadvantage is that the problem could recur. Regular follow-up visits to the doctor who performed the treatment, will guard against recurrence and ensure any recurrence is detected early.
How do doctors treat melanoma?
Melanoma is the most serious type of skin cancer, but early detection and surgical removal leads to good outcomes. Treatment options depend on the extent of the disease, age, general health, and the location of the melanoma.
In most cases surgery is the only treatment required. A safety margin of normal tissue around the melanoma is removed along with the tumour, to prevent local spread. A pathologist will examine the surgical sample to ensure the safety margin is adequate. Sometimes a second operation needs to be performed.
Advanced melanoma means that the cancer has spread to other organs, or the lymph nodes, in which case chemotherapy and radiotherapy may be employed to halt further advancement. Compared with other advanced cancers, melanoma has proven the least receptive to treatment. Only 15% of patients respond to chemotherapy, which has significant side affects.
Molecular targeted therapy, such as BRAF, NRAS, CKIT, target the key molecular mutations in melanoma that drive the formation of tumours. Targeted therapies are still in the research phase but are in clinical use where suitable. As is the case for other cancers, not all melanomas are the same. Doctors have now identified some of the molecular mutations responsible, but many more still need to be found.
The immune system and skin actually respond naturally to fight melanoma and a tumour can regress. Unfortunately, the tumour may have already spread to other organs to form metastases, which are resistant to the body’s normal immune response.
Recent research into immunotherapy against melanoma, to enhance the body’s immune response, has shown promise. Immunotherapy includes using interferon, allogenic vaccines, extracts from the patient’s melanoma, and dendritic cell vaccines. Critical, life-saving research is underway to fully explore these new treatments.
How do doctors treat prostate cancer?
If prostate cancer is detected and treated while still confined to the prostate gland, a cure is possible. Asymptomatic prostate cancer that remains confined to the prostate gland may simply need regular surveillance by a urologist.
Surgical removal of the entire gland might be performed or radical radiotherapy might be employed to cure the cancer. Radiotherapy can be applied externally or using brachytherapy, which involves injecting ‘radioactive seeds’ into the prostate gland.
Advanced prostate cancer may respond to hormone therapy, which reduces the stimulus of male hormones. A combination of early radiation therapy and hormone therapy has been shown to improve outcomes. If hormone resistance occurs, chemotherapy might be used instead. Bisphosphonates are used to strengthen bones and guard against bone secondaries, because prostate cancers metastasise readily to bones.
How do doctors treat bowel cancer?
The type of bowel cancer treatment will depend on the location of the tumour, whether the colon or rectum is involved, and how advanced the cancer is. Treatment may involve surgery, chemotherapy, biological therapy, or radiation therapy. Some people need a combination of treatments.
Surgery is the main local treatment for bowel cancer. The surgeon removes the section of the bowel affected by cancer and then rejoins the normal bowel end-to-end. Occasionally, a stoma is created during the surgery, which is usually temporary, although some people need a permanent stoma. A stoma diverts bowel motions from the distal bowel to an attached bag.
If surgery is not an option, then chemotherapy and radiotherapy are offered to halt progression of the disease and control symptoms.
Radiotherapy is another local treatment that uses targeted high-dose radiation to kill cancer cells. Radiotherapy is usually used in addition to surgery, depending on a patient’s needs.
Chemotherapy and biological therapy are systemic therapies. An intravenous drug enters the blood stream with the aim of controlling cancer throughout the body.
How do doctors treat breast cancer?
The aim of breast cancer treatment is to remove the cancerous mass and destroy any remaining cancer cells locally or outside the breast.
Following a full evaluation to determine the type and extent of breast cancer, treatment options can be customised to suit the individual, based on extensive knowledge of which treatment results in the best patient outcome.
Your doctor will determine whether the lymph nodes under your arm or elsewhere are affected. Whether the cancer cells have oestrogen receptors or progesterone receptors also will be determined.
Other factors that affect the treatment are the size of the lump, how quickly it is growing, and whether menopause has occurred.
Surgery will involve either a lumpectomy (just the lump removed) or mastectomy (the entire breast removed) with or without axillary lymph node removal. Additional treatments that may be used are radiotherapy, hormonal therapy, and chemotherapy.
For early breast cancer, lumpectomy followed by radiation treatment has a similar outcome to mastectomy. These days a lumpectomy with removal of affected lymph nodes, followed by radiotherapy, is the most common treatment used for early breast cancer.
Sentinel node biopsy will determine the dominant affected lymph node, which will be examined for cancer cells. If the sentinel node does contain cancer cells, additional lymph nodes from the armpit will be removed.
A mastectomy means the removal of all the breast tissue, including the nipple and areola. A radical mastectomy includes removal of all armpit lymph nodes and adjacent muscles.
Radiotherapy is targeted high-dose radiation that kills cancer cells and reduces the risk of the cancer recurring.
In addition, hormonal therapy and chemotherapy may be used after breast surgery to prolong survival. A woman with a higher risk of recurrence is more likely to need hormonal therapy or chemotherapy, or both. Hormone therapy controls hormones that the cancer responds to. Chemotherapy is an intravenous drug delivered over a period of months to kill cancer cells. Hair loss, vomiting, and fatigue are common side effects.
A bisphosphonate drug may benefit a patient when cancer has spread to the bones. These drugs are used to strengthen bone mass and reduce the chance of fractures and pain.
Benign phyllodes tumours are surgically removed along with a margin of normal tissue, because these tumours have a high likelihood of becoming malignant.
Malignant phyllodes tumours are surgically removed along with a wider margin of normal tissue and surgery is often all that is needed. When a malignant phyllodes tumour has spread beyond the breast, chemotherapy is used to improve prognosis.
How do doctors treat lung cancer?
Treatment options for lung cancer depend on the type of cancer, the stage or extent of disease, the severity of symptoms, and the person’s general health state.
Lung cancer can be treated with chemotherapy, radiotherapy, and surgery to remove tumours. Sometimes two or even three of these treatments are used in combination.
Small cell carcinoma is usually treated with chemotherapy. If the cancer is limited to one lung, chest radiotherapy may be performed to reduce the likelihood of spread. Due to the invasive nature of small cell carcinoma, surgery is usually not an option.
If the cancer is operable stage 1 non-small cell carcinoma, the area is limited to the lung and well defined. Surgical removal of the effected lung may be possible, either by minimally invasive lobectomy or open lobectomy. Another possible treatment is surgical removal of the mediastinal lymph nodes, if they are affected.
Non-small cell lung cancer can be treated with surgery, radiotherapy, or chemotherapy and the treatment will depend on the stage of disease at the time of detection, and the general health of the patient.
Surgical removal is rarely an option for a person with mesothelioma. However, chemotherapy treatment or thoracentesis (removal of fluid or air from the chest) might be used to slow the progress of disease and ease symptoms.
Survival rates vary depending on the stage of cancer at the time of diagnosis, which means the size of the tumour and whether the disease has spread to other organs. As is the case for all cancers, early diagnosis of lung cancer and treatment results in better patient outcomes.
Research into new treatments continues to provide more effective and targeted treatments for people with cancer. Australia is at the forefront of research. A patient might be asked to take part in a clinical trial to test new ways of treating lung cancer.
How nutritional medicine specialists treat and prevent cancer
Nutritional status is extremely important to: carcinogenisis (the start of cancer), cancer cell oncogene activity, and the immune system response to the new mutated cancer cells. Multiple harmful nutrition-related factors can increase cancer incidence, cancer growth and spread, and a person’s ability to survive.
These factors may include:
- Food chemicals and carcinogens that directly alter DNA replication
- Poor antioxidant status with increased oxidative damage,
- Inadequate intake of nutrients that support DNA synthesis, repair, and methylation (making DNA stable and essential for normal development)
- Nutrient deficiency that adversely affects cell differentiation and proliferation
- Imbalanced Essential Fatty Acid intake that adversely promotes production and release of pro-inflammatory cytokines (promote inflammation) and eicosanoid mediators (control immunity and inflammation)
- Dietary factors that alter hormone metabolism and balance and production of cellular growth factors, or
- Specific nutrient deficiency that compromises immune system competency
Prevention is the best form of cancer therapy
In order to prevent cancer, a person needs to avoid:
- Toxic environments, such as chemicals, heavy metals and radiation, and high stress living
- Toxic foods such as trans fats, saturated fats, barbecued meats, baked goods, and high GI/GL foods
Health choices to emphasise:
- Beneficial foods such as protein, fibre, fruits, and vegetables
- Regulate carbohydrate intake
- Clean environments
- Relaxation and meditation practice
Critical factors for cancer treatment in nutritional medicine
Critical factors for cancer treatment
- Evaluate molecular biology of tumour cell population
- Analyse tumour cell sensitivity to chemotherapy agents
- Protect against anaemia
- Inhibit COX-2 enzyme activity
- Suppress Ras oncogene expression
- Correct coagulation abnormalities
- Maintain bone integrity
- Inhibit angiogenesis
- Block collagen lysis
- Maintain nutritional status
- Accessory cytotoxic therapy
Evaluate molecular biology of tumour cell population
- Tumour promoting genes
- Tumour suppressor genes
- Cell receptor sites – signalling “docking” sites
- Cellular differentiation
Analyse tumour cell sensitivity to chemotherapy agents:
- Chemo-sensitivity testing allows for assay-directed therapy
- Improve prognosis
Protect against anaemia
If a person with cancer develops anaemia, the risk of death increases by 65%.
Factors that lead to anaemia include:
- Inhibition of bone marrow activity due to chemotherapy
- Nutrient deficiency
- Cancer-related increased cytokine release – TNF-a and IL-1
Anaemia stimulates vascular endothelial growth factor (VEGF) release due to intratumoural hypoxia, which inadvertently promotes angiogenesis and tumour cell growth. Cancer-related anaemia responds to erythropoietin therapy with optimal haemoglobin (red blood cell) levels for men 130-170 g/L, and 120-150 g/L for women.
Iron, folate, vitamin B6 and zinc nutrient deficiencies need to be assessed and treated in patients with cancer.
COX-2 enzyme activity inhibition
Treatment should include COX-2 enzyme activity inhibition
- COX-2 mediated arachidonic acid metabolism produces prostaglandin E2 (PGE2), a pro-inflammatory eicosanoid
- Unduly elevated COX-2 activity stimulates cancer cell growth via angiogenesis and NF-Kappa-B activation
- Hypoxic zones in solid tumours upregulate COX-2 activity, for example pancreatic cancer shows 60-fold increase
Non-steroidal anti-inflammatory drug (NSAID) therapy reduces COX-2 activity and improves response to cancer therapy. NSAID drugs include aspirin, ibuprofen, and naproxen, which are available without a prescription. However, COX-2 inhibitors and NSAIDS are associated with a high rate of adverse effects, including gastrointestinal disorders.
COX-2 Inhibition: many natural products inhibit COX-2 activity without the adverse effects of medications
- Green tea epigallocatechin gallate (EGCG)
- Curcumin reduces TXA2 and PGE2
- Ginger inhibits COX-2 and regulates COX-1
- Feverfew inhibits both COX and LOX and reduces HETE which promotes angiogenesis
- Berberine as Goldenseal, Oregon Grape Seed multiple reports of reducing cancer activity
Ras oncogene expression
Ras proteins integrate the regulatory signals that govern the cell cycle and proliferation, which is important in uncontrolled tumour growth.
Ras proteins bind to inner cell membranes and behave as a relay switch, and respond to external cell stimuli to activate internal pathways that direct cell division, differentiation, and even apoptosis. Ras proteins de-activate when the signal ceases.
Mutations in the H, N or K-Ras genes cause cancer and tumour cell proliferation. Ras gene mutations occur in 30-40% of all human cancers – pancreas 80%, colon 50%, lung 40% and liver 30%, melanoma 30%, and myeloid leukaemia 30%. Mutated Ras protein are always in the active form, which leads to persistent signal to cell division and proliferation and leads to tumour growth.
Therapies that suppress Ras oncogene expression include statin therapy to inhibit HMG-CoA reductase that will reduce farnesyl pyrophosphate production, which is essential to Ras protein maturation. In patients with primary liver cancer, statin therapy plus 5-FU has been shown to double a person’s median survival time, from nine months to eighteen months.
Omega-3 essential fatty acids reduce Ras protein localisation to cell membrane and markedly improve survival times; more than a year terminally ill cancer patients compared with a three-month survival in patients not given Omega-3 essential fatty acids.
Citrus oil extract contains limonene, which inhibits farnesyl transferase and reduces Ras protein maturation. Animal studies report reduced cell replication.
Garlic or allium sativa contains diallyl disulphide, which inhibits H-Ras oncogenes and significantly restrains tumour growth and lung cancer induced cell death. Garlic also contains an organic compound called S-allyl cysteine, which inhibits human melanoma cell growth and also counters the toxic effect that the chemotherapy drug Doxirubin has on the heart. Garlic also boosts immune system function and antioxidant capacity. Aged garlic extract seems to be most effective form for cancer treatment.
Green tea polyphenols inhibit Ras oncogenes and also reduce NF-Kappa-B activity. Multiple studies report a beneficial impact on chemotherapy response, enhanced cancer cell apoptosis and long-term survival.
Correct coagulation abnormalities
Hyper-coagulation problems (increased risk of blood clots) commonly occur in cancer patients, which can lead to overt vein thrombosis and pulmonary embolus. The fibrin deposition on cancer cell surfaces promotes angiogenesis and retards immune recognition.
Low-molecular weight Heparin used to reduce hypercoagulation problems reportedly reduces mortality rate after surgery, improves long-term survival, and reduces the incidence of metastatic disease.
Nutritional medicine specialists look for low-normal PT and PTT with high-normal D-dimer, Fibrin-split products (FSP), fibrinogen and platelet count, and also elevated alpha-1-antitrypsin and Factor VIII.
Several natural products may be helpful including:
- Quercetin and bromelain may increase fibrinolysis
- Pancreatic enzymes in high doses are reportedly effective in removing fibrin deposits
- Omega-3 essential fatty acids and mixed tocopherols are reported to reduce platelet activation
- Garlic and ginkgo biloba also reduce platelet activation
Maintain bone integrity
The maintenance of bone health and integrity is essential in patients with all forms of cancer. Many types of cancer show a tendency to metastasise to bone, in particular breast and prostate cancer. Osteopenia and osteoporosis commonly occur following chemotherapy and anti-hormone therapy.
Prostate cancer cells produce IL-6, which promotes bone loss. Bone loss increases the production of bone-derived growth factors, such as TGF-beta1. These growth factors further stimulate prostate cancer cell growth. Bisphosphonate therapy improves bone integrity and markedly reduces metastatic bone disease. Bisphonsphonates are a class of drugs that prevent the loss of bone mass used to treat osteoporosis and similar diseases.
A patient with cancer should always have bone density and urinary telopeptide levels assessed, in particular prostate cancer.
Nutrients for bone health include:
- Calcium, magnesium, zinc & boron
- Protein and essential amino acids, such as Lysine
- Vitamin C
- Vitamin D and vitamin K stimulate osteocalcin activity
- Possible role also for fluoride and strontium therapy
Inhibit tumour angiogenesis to halt tumour growth
Solid tumours cannot grow beyond 2cm3 without a blood supply. Tumour growth occurs concurrently with rapid vascularisation, also called angiogenesis, which is triggered by angiogenic growth factors produced by cancer cells.
Many agents promote angiogenesis including oestrogen, IL-8, TNF-alpha, PGE2, growth factors, and intratumoural hypoxia. Interruption of angiogenesis reduces tumour growth. Angiostatin and endostatin
showed a 100% success in mouse model research and Thalidomide also will interrupt tumour growth.
Many natural agents also inhibit angiogenesis activity:
- Curcumin and green tea
- Retinoic acid and vitamin D
- Chondroitin and various cartilage extracts
Block collagen lysis
Cancer cells spread enzymes that dissolve collagen and hyaluronic acid. Collagen synthesis may be stimulated by high-dose ascorbate, lysine and proline, which have been reported to retard cancer cell growth and induce cancer regression with the side benefit of improved energy, possibly related to improved carnitine synthesis.
Maintain nutritional status
Multiple nutrient imbalances are commonly present in patients presenting with cancer:
- Protein/carbohydrate intake ratio imbalance with insulin resistance, excess protein catabolism, and lipogenesis
- Antioxidant depletion – ascorbate, tocopherols and flavonoids, coenzyme Q10, glutathione, lipoic acid
- High omega-6/omega-3 EFA balance
- Mineral deficiency – zinc, selenium, magnesium, chromium and possibly iron
Nutrient depletion of vitamin B6, folic acid, and niacin need to be assessed in a patient with cancer and treated if deficient.
- Gastrointestinal disturbance in the form of maldigestion related to stress, dietary imbalance, food reactivity, or impaired protein synthesis
- Bowel dysbiosis related to both maldigestion and prior antibiotic or steroid use
- Hepatic detoxification disorder – both Cyp450 activity and impaired conjugation reactions
Hormone imbalances such as low DHEA and possibly melatonin need to be assessed.
Systematic and integrated nutritional medicine treatment plan
- Antioxidant capacity
- Essential fatty acid balance
- Bowel dysbiosis
- Specific therapy
- Neurotransmitter balance
- Hepatic detoxification
- Hormonal balance
Accessory cytotoxic therapy through intravenous ascorbate protocol – Dr Mel Sydney-Smith
High-dose ascorbate therapy should be given by intravenous (IV) drip twice per week if possible, in particular after surgery and during radiation and chemotherapy.
Because of the remote risk of renal oxalosis, it is important to always check renal function before and after IV ascorbate treatment. Adding vitamin B6, zinc, magnesium, lipoic acid and gonadogrophin (GTH) enhances the effect. Consider high-dose oral lysine to compliment ascorbate therapy.
IV ascorbate protocol:
- 800ml distilled water
- Sodium ascorbate – 30-60gm
- Sodium bicarbonate 8.4% solution – 10-15ml
- Lipoic acid – 400mg
- Trace elements – 5ml
- zinc 5mg (ZnCl), copper 1mg (CuCl)
- manganese 0.4mg (MnCl)
- chromium 0.02mg (CrCl)
Before the ascorbate infusion, measure renal function and 24-hr urine oxalate to test for G-6-PD deficiency if the patient is of African or Mediterranean descent. Ensure the patient is already taking high-doses of vitamin B6, coenzyme Q10, vitamin K2 or K3.
Warm the patient’s arms in hot water. Always infuse via a catheter, which reduces chance of tissue infusion. Start with just a low dose of ascorbate (10gm in 300ml water). Run infusion slowly first 2-3 times (over 3-4hrs). Infuse twice per week if possible. The frequency can be reduced to once per week if the patient improves.
The main adjunctive nutrient therapy for cancer treatment
Adjunctive nutrient therapy for a patient with cancer:
- Alpha-lipoic acid – 600-800mg/d
- Vit D3 – 2000-5000 U/d
- Vit K2 – 20mg/d
- Coenzyme Q10 – 300-600mg/d
- Conjugated linoleic acid
- Berberine HCl – 900-1500mg/d
- Curcumin (water soluble) up to 6 cap/day
- Green Tea extract – 3-4 cap/day
- Omega-3-EFAs – up to 6gm/day
Other adjunctive nutrients for cancer treatment
Adjunctive nutrients include:
- Goldenseal, Oregon grape seed
- Feverfew, ginger, garlic
- Modified Citrus pectin
- Oriental mushroom extracts
- Milk thistle
- Soy protein and isoflavones
- Thymus extract
- Vitamin A
- Tocopherols and tocotrienols
More adjunctive medications for cancer treatment
- Statins therapy + Co-enzyme Q10
- Hormonal therapy – DHEA, melatonin
Complementary Alternative Cancer Therapies
Cancer Treatment: The Critical Factors
Cancer Adjuvant Therapy
Glossary – cancer-related medical terms
Adenocarcinoma – malignant neoplasm of epithelial cells with a glandular or gland-like pattern.
Aldara – a topical ointment that contains Imiquimod, which is used to treat basal cell carcinoma
Anaemia – low haemoglobin levels
Angiogenesis – creation of new blood vessels
Assay-directed therapy – determines if a treatment is useful for inhibiting tumour growth before administering it to a patient
Basal cell carcinoma – BCC one type of non-melanoma skin cancer
Bisphosphonate – are a class of drugs that prevent bone loss, used to treat osteoporosis and similar diseases
BRCA2 gene – a mutation of this genes means a person has a higher risk of ovarian, breast, or prostate cancer
Bronchoscopy – direct visualisation of the bronchi through a tube inserted through the mouth under anaesthetic
Cancer cachexia – describes a syndrome of progressive weight loss, anorexia, and persistent erosion of host body cell mass in response to a malignant growth.
Carcinoembryonic antigen – CEA is produced in high quantities by some cancer cells, especially in bowel cancer.
Carcinogenisis – the process by which normal cells are turned into cancer cells
Chemo-sensitivity – effectiveness of chemotherapy in stopping cancer growth
Cytotoxic therapy – Any agent or process that kills cells
DHEA – dehydroepiandrosterone is an endogenous hormone secreted by the adrenal gland.
DNA – Deoxyribonucleic acid is a molecule that encodes the genetic instructions of all known living organisms and many viruses
DNA methylation – an essential part of normal cell development and is associated with a number of key processes
DNA synthesis – the natural or artificial creation of DNA
Eicosanoid mediators – exert complex control over many bodily systems, mainly in inflammation or immunity
Imiquimod – an immune response modifier that activates immune cells in the body
Intratumoural hypoxia – lack of oxygen supply within a tumour
Haemoglobin – iron-containing oxygen-transport metalloprotein in the red blood cells
Fluorouracil or 5-FU – an antimetaboite chemotherapy that kills rapidly dividing cancer cells, such as solar keratoses and BCCs
Limonene – found in citrus oil extract, inhibits farnesyl transferase and reduces Ras protein maturation
NSAID (non-steriodal anti-inflammatory drug)– class of drugs that provides reduce pain and fever, and, in higher doses, inflammation
Oncogene – a gene that has the potential to cause cancer
Osteopenia – bone density that is lower than normal
Osteoporosis – when a person has porous and are susceptible to fracture, associated with ageing
Proinflammatory cytokines – promote inflammation
Solar kertaoses – a type of non-melanoma skin cancer
Squamous cell carcinoma – a type of non-melanoma skin cancer